Urgent Care Centers Reduce Emergency Department Visits, Costs Increase

Urgent care centers are associated with increased spending for lower-acuity visits compared to emergency department (ED) visits, according to a study published in Health Affairs. These centers increase access to health care, but pose risks for health insurers and patients who must pay these increased costs.

Prior research suggested that the greater availability of urgent care centers resulted in fewer ED visits, with lower acuity complaints like rash, muscle strain, bronchitis, and urinary tract infection. Researchers found that urgent care centers also increase the number of individuals seeking care; for every 37 urgent care center visits, one fewer lower acuity ED visit occurs.

The researchers analyzed a claims database with more than 20 million patients per year covered by a national managed care plan from January 1, 2008, to December 31, 2019, assessing how the number of lower acuity ED visits changed when an urgent care center visit occurred within each ZIP code. They found that by 2019, the opening of an urgent care center led to a decline in the number of lower acuity ED visits, and that these ED visits were approximately 10 times more expensive than urgent care center visits. Additionally, due to the high substitution ratio—the number of urgent care visits needed to deter a single ED visit—costs increased even though urgent care center visits are less expensive than ED visits. Each $1646 lower-acuity ED visit prevented was offset by a $6327 increase in urgent care center costs.

“We should evaluate new care models and interventions on the same standard as we evaluate new drugs—do they improve lives more than they increase costs? That's the important metric,” said Ari Friedman, MD, PhD, an assistant professor of Emergency Medicine, Medical Ethics and Health Policy in the Perelman School of Medicine at the University of Pennsylvania, in a prepared statement. “But the cost increases here are so large that the value side of the equation would have to do a lot of work to make it pay off.”

The study authors noted that it’s possible that the availability of urgent care centers in a market, when combined with telemedicine, primary care, and changes to benefits, could have an effect on the substitution ratio. Additionally, beyond the question of access, the clinical benefit of these additional visits to unscheduled care requires further research, as does the impact and role of telemedicine.

REFERENCE

Urgent care centers deter some emergency department visits, but costs remain high [news release]. EurekAlert; April 5, 2021. Accessed April 20, 2021. https://www.eurekalert.org/pub_releases/2021-04/uops-ucc040121.php